How to Prevent and Recover from a Stress Fracture

Don’t ignore that pain in your foot — it could be an early sign of a preventable stress fracture.

A stress fracture is an overuse injury consisting of small cracks in the bone. It often affects the metatarsals or lower leg bones. If you have a stress fracture, you’ll likely notice bruising, sudden and severe pain, and localized tenderness. This injury may arise over time, with the bone becoming progressively swollen and sore. While a stress fracture is relatively simple to treat, proper prevention can help you avoid this painful condition altogether.

WHAT CAUSES A STRESS FRACTURE?

Stress fractures often affect the weight-bearing bones of the lower body. They are especially common in athletes, or anyone with an active lifestyle. This injury can be caused by the repetitive force of running, walking, or jumping, or a weakening condition of the bones such as osteoporosis.

Stress fractures particularly affect young people, women, and the elderly. Adolescents, whose bones are still developing, may suffer from injuries associated with overtraining. Women, especially those with hormonal irregularities, are statistically at an increased risk. Finally, elderly people may have osteoporosis or decreased bone mass, and should be aware of any low-level pain, as this may progress to a fracture even with normal, non-strenuous activity.

PREVENTING STRESS FRACTURES

To avoid developing a stress fracture, proceed with caution when trying new exercises or upping the intensity of your workout. The key is to change your activity level gradually, giving the bones time to adjust, as bone tissue naturally degenerates and rebuilds to accommodate the new force. Athletes should also be sure to wear supportive footwear.

As a runner, you should gradually shift the distance and pace of your run. Experts suggest adding no more than 10% of your usual distance per week. A shorter and quicker running stride can also be easier on the bones — some experts recommend about 80 to 90 steps/minute per foot. Strong calf muscleswill help strengthen the tibia in the leg, preventing fractures by absorbing the impact. Daily calf raises can develop these muscles, particularly for women runners.

To strengthen bones, try adding more vitamin D and calcium to your diet. Stress fractures are also more common in people with overpronation in their feet, and these patients should talk to a doctor about preventative orthotics.

TREATMENT OPTIONS

If you have a stress fracture, the first step is to cease activities that put pressure on the injured bone. You can use ice and anti-inflammatory medication to relieve pain at home, but should still seek a doctor’s diagnosis. An orthopedic specialist can run an X-ray or bone scan to develop a personalized healing plan for your condition. An MRI may be necessary if the fracture does not show up on the X-ray, as MRIs can also detect a stress reaction preceding a full fracture.

As you heal, your doctor may suggest a cast, traction tape, or protective footwear to provide additional support. You’ll need to stay off the bone as much as possible, often by using a cane or crutches. For the six to eight weeks it typically takes to heal, you should avoid running and walking, but low-impact exercises like swimming can be beneficial. In some more serious cases you may need surgery, which involves inserting a screw or plate into the bone to add support. After this procedure, you can return to activity gradually, giving the bone time to adjust.

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